Welcome to the Privacy Web Form

You can use this form to submit a request regarding your personal information.

Please complete this form and we will respond as soon as possible.

For more details and information about how we use and protect your personal information, please visit our Employee Privacy Policy.

Please note that if you wish to exercise rights with respect to any Protected Health Information (PHI) which Teladoc stores about you, please use this form instead and specify that you are a Member.

Myself
Someone for whom I am acting as an authorized Agent or Personal Representative